What Is a Pressure Injury? A Caregiver’s Guide to the Basics - Part 1
Posted by Michael Russo, BS, RRT, CEAC, ATP - Home Medical Equipment Expert on
A pressure injury—also called a bed sore—is a wound caused by staying in one position too long. This often happens to people who use a wheelchair or stay in bed for most of the day. These injuries usually form over bony areas like the tailbone, heels, or hips.
The injury forms when skin and tissue are pressed between bone and a surface like a mattress or wheelchair seat. This pressure cuts off blood flow, damaging the tissue—even before anything shows on the skin.
🧠 Did You Know? Experts now use the term “pressure injury” instead of “pressure ulcer.” It helps describe what’s really happening: tissue damage often starts under the skin, before a wound opens up.
What Are the Stages of a Pressure Injury?
Pressure injuries are grouped by how deep they go:
- Stage 1: Red or discolored skin that doesn’t fade when touched.
- Stage 2: An open sore or blister with pink or red tissue.
- Stage 3: A deeper wound, sometimes showing fat or signs of infection.
- Stage 4: The most serious stage—may expose bone or muscle.
- Unstageable: Covered with scabs or dead tissue, so it’s hard to tell how deep it is.
- DTI (Deep Tissue Injury): A deep bruise under the skin that can break down quickly.
Who Needs Pressure Injury Prevention the Most?
Some patients are at a much higher risk for pressure injuries due to their medical condition and inability to move on their own. These individuals often qualify for a Complex Rehab Power Wheelchair (Group 3) with advanced pressure-relieving features like tilt, recline, and custom seating.
Common diagnoses that may qualify under Medicare guidelines include:
- ALS (Amyotrophic Lateral Sclerosis)
- Parkinson’s Disease
- Multiple Sclerosis (MS)
- Stroke with hemiplegia
- Spinal Cord Injury (SCI)
- Cerebral Palsy (CP)
- Muscular Dystrophy
- Traumatic Brain Injury (TBI)
- Guillain-Barré Syndrome (GBS)
- Post-Polio Syndrome
- Huntington’s Disease
- Severe Rheumatoid or Osteoarthritis
- Osteogenesis Imperfecta (brittle bone disease)
- Amputation (especially bilateral lower extremity)
- Progressive neurological or orthopedic conditions
- Obesity-related immobility or frailty with pressure risk
If your loved one can’t shift their weight independently or has had a pressure injury before, it’s time to consider a seating system that protects their skin and improves their daily comfort and independence.
Real-World Example
Let’s say a person with Parkinson’s sits in a wheelchair all day. If they don’t have the right cushion or back support, their tailbone area stays under pressure. This can cause internal skin damage before any visible signs appear on the surface. Without early intervention, it can turn into a serious wound.


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